Freud's Free Clinics

1923–1932: THE MOST GRATIFYING YEARS
directors of the clinic. Reich seemed to be privileged with apparently limitless
visits to Freud, who bemusedly noted Reich’s Steckenpferd (hobbyhorse),
his obstinate conviction that neurosis, whether individual or social, is rooted
in sexuality. 9 But he was genuinely well regarded by the analysts and especially
appreciated for his imaginative, charismatic chairmanship of the Technical
Seminar. Reich held these meetings weekly initially at the Ambulatorium
and, from 1925 until 1930 when he moved to Berlin, at the Vienna
Psychoanalytic Society’s Institute. 10 Reich’s initial seminar papers, where he
pursued his earliest theoretical sketches of a new therapy based on individual
character structure, were surprising not only for their content but also for
their structure. Psychoanalysis, he said, should be based on a careful examination
of selected unconscious character traits, later called ego defenses, that
impede an individual’s acceptance of their natural self in society. Else Pappenheim,
more a friend of Annie Reich than of Wilhelm, remembered the
later popularity of “his book on character analysis that we all read. It was part
of the curriculum. And,” she commented, “he was very respected in Vienna
at the time.” 11 Reich called for a new approach to the analysis of individual
character. In due course he devised the format of the in-depth individual case
conference, a format that still endures as the standard method for systematically
summarizing and discussing therapeutic issues in clinical settings.
Though a mere twenty-seven pages of handwritten minutes of the seminar’s
case reports have survived, the analysts’ lively exchanges and imaginative critiques
make clear why these sessions were some of the most valuable activities
of the society. 12 The analysts met in the windowless conference room of
the Ambulatorium and, in at least the discussions of January 9, February 6,
March 5, May 7, and October 1, 1924, supported each other’s efforts to treat
all those who requested clinical treatment—without regard to fee. When Reich
entered the conference room after a full day in the clinic, his relative
youth vanished. He spread an electrifying energy all his own; his deep-set
eyes, wavy hair, and high forehead of the rebellious German intellectual barely
tempered by the military mannerisms of a Prussian army official. Under
his leadership the analysts developed not only path-breaking clinical protocols
but also attended to the more mundane aspects of running a clinic. They
formalized the staff, record-keeping, and statistical requirements of the clinic
for both internal use and public scrutiny. As a branch society, the Viennese
would send off these reports for publication and distribution by the IPA.
Reports from the IPA’s branch societies’ activities had shifted, as of 1920,
from the Zeitschrift to the International Journal of Psychoanalysis (IJP). Local
groups around the globe forwarded to the IJP’s editors the minutes of their
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